Do You Agree With My Choice For 800cc High Profile Under Muscle Saline Implants?(photo)

The larger you go, the greater percentage of your final breast volume will be implant, and the more your breasts will look, behave, and feel like the implants.  Because the texture of silicone gel, due to its viscosity, is more natural than saline, the larger you go, the more advantageous gel implants become.  My recommended max for you is 600-650 ml, depending on chest width, and at that size, gel is preferred over saline.  Large saline implants also more prone to rippling and wrinkling.

800 cc breast implants are very large implants.  I would be interested in seeing how you came to this conclusion.  In my practice, we do a combination of things to determine the size that you would be happy in. 


Trying on implants in a bra and under clothing

Dimensional analysis fitting the "right" dimension of implant to your frame

3D imaging so that you can "see" the changes in your body before surgery


If you feel that you have accurately determined 800 cc is the correct implant size for you, you may be right (but I doubt it).  In my practice, this is a very large implant and would likely do best in stages with an initial implant in the 500 cc range.

800 cc saline implants WILL give you a rounded upper pole and very augmented appearance.  The feel of the breast will be very unnatural, which it sounds like is not what you are interested in.

Thank you for including photos, and the comment that you "don't want upper pole fullness." I'm not sure what "prep" is, but you should take the suggestion that others have given and wear 800cc implants in your bra for a few hours and see what that looks and feels like. How did you and your PS arrive at 800cc?

800cc is over 3 cup sizes larger than what you have now, and even though you have some breast droop, your nipples are above your inframammary crease, and augmentation alone is all that is needed to give you a good result. However, adding over 3 cup sizes into your skin brassiere will undoubtedly give you a high, tight, rounded look that certainly adds upper pole fullness--that volume has to go somewhere. It may also give you an inframammary double bubble deformity as your implant causes a "new" lower inframammary crease below your natural one.

Furthermore, you should be considering silicone for the softest, most natural feel and to avoid the possibility for requiring re-operation if your saline implant(s) leak and deflate, which cannot happen with the latest generation of cohesive silicone gel implants. Below the muscle will help to keep the upper pole fullness down compared to above the muscle, and below the muscle also has the lowest likelihood of bacterial contamination (from intraductal bacteria) that can lead to capsular contracture (which will give you HARD, high, tight upper pole fullness).

Truly, I am usually the plastic surgeon on this site who champions patient choice--in coordination with the surgeon's assessment of your anatomy--regarding implant size, and I do use 800cc implants on occasion. I just really question your surgeon's judgement and experience if he/she condones, agrees, or promotes this choice for your anatomy. Have you shown your surgeon photos of patients or nude models with the breast size and appearance you desire?

Reschedule surgery and get another or two consultations and see if 800cc is offered by experienced, ABPS-certified plastic surgeons with lots of breast experience. If you can get one or more PS to agree with this plan, then you can always go ahead. But if not, you should realize there IS a reason that virtually all of your on-line experts are in agreement that this will be a huge mistake, and one that perhaps cannot be undone by simply "exchanging for smaller implants." You can always go bigger, but going smaller is much more problematic.

Good luck and best wishes!

Hello again Itskasey,

Wow.  You really don't get it.  Read the other doctor's posts, I'm not just one lone opinion that doesn't match the other doctor's opinions (except of course the doctor you're choosing).  We are all telling you this is a bad idea.

Based on your photograph you have provided, and what you've said about not wanting upper pole fulness, you will not be happy with your choice of 800 cc HP.  HP is all about more pronounced upper pole fullness, and an 800 cc implant has no where to go on you but up.  Looking at your photograph, your nipple to inframammary fold distance appears relatively short, which means he will have to significantly lower your fold to properly position this large implant under the breast mound, and to keep your nipples from pointing south.  Pinch your skin just under your breast; that will be all that is covering the bottom of the implant afterward.

One other thing to consider is that this will not be a reversable event in case you think you'll just go for it, and if you don't like it, you'll just 'change them out for another pair'.  This will cause irreversable and possibly uncorrectable problems for you.  This is really serious!

As the others have told you, nows a time to be thoughtful, not rash.

I hope you reconsider.

Without seeing you in person, it is impossible to give you specific advice.  However, 800 cc implants are very large.  At your visit tomorrow, have them give you two 800 cc implants in put them in your bra and then go walk around town for an hour and bring them back.  This will give you an idea of what you are getting into with such large implants.  

 

Good Luck.

I would caution against an implant of this size.  It will most definitely lead to implant complications.  Generally speaking,larger implants increase the risk of complications such as implant malposition, which can be very difficult to correct longterm.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

800ccs is a very large implant for a primary augmentation!  You state that you don’t want upper pole fullness, but this implant will likely give you a very unnatural result.  Have a discussion with your surgeon sooner rather than later regarding your surgical goals.

I am not sure how the size of 800cc was selected for your body frame and breast base width. Besides being way too big for base width, implants of that size will give you a very round breast appearance and a lot of upper pole fullness...exactly what you say you don't want. It is more likely that the right size wwould be closer to 800cc total for both breasts combined or 400cc to 450cc per side.

High profile saline filled implants will definitely yield a very round breast with superior breast fullness.   The upper pole will be more shelf like as opposed to a moderate plus profile.  In addition, an 800 cc implant weighs almost 2 pounds.  It is important to remember that time weight and gravity are not on your side.   While it is possible to make breasts very large it does have consequences and some of these may not be desirable.  As a plastic surgeon I try to take patients from what is possible to understanding their own tissue dynamics and the effects of implants over time.  It would be best to fully discuss your options.  

Sounds like the jury is in... but it comes down to what your want and what you are willing to accept in terms of risk and long term issues.  I hope you were able to resolve your concerns with your doctor and that you are able to get what you want. 

800 cc's will be large on you, obvious, and produce consider upper pole fullness.  Depending on the dimensions, it could also make you nipples appear like they are pointing outwards.  Good luck!